Original Article

Langenbeck's Archives of Surgery

, Volume 392, Issue 4, pp 465-471

First online:

Improved collagen type I/III ratio at the interface of gentamicin-supplemented polyvinylidenfluoride mesh materials

  • Karsten JungeAffiliated withDepartment of Surgery, Technical University of AachenGerman Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen Email author 
  • , Uwe KlingeAffiliated withDepartment of Surgery, Technical University of AachenHelmholtz-Institute of Biomedical Engineering, Applied Medical Engineering, Technical University of AachenGerman Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen
  • , Raphael RoschAffiliated withDepartment of Surgery, Technical University of AachenGerman Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen
  • , Petra LynenAffiliated withIZKF BIOMAT, Technical University of Aachen
  • , Marcel BinneböselAffiliated withDepartment of Surgery, Technical University of Aachen
  • , Joachim ConzeAffiliated withDepartment of Surgery, Technical University of Aachen
  • , Peter R. MertensAffiliated withMedical Clinic II, Technical University of Aachen
  • , Robert SchwabAffiliated withDepartment of Surgery, Technical University of Aachen
  • , Volker SchumpelickAffiliated withDepartment of Surgery, Technical University of Aachen

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Background

Formation of recurrent inguinal and incisional hernia shows an underlying defect in the wound-healing process with an insufficient quality of scar formation. Even after mesh repair an altered collagen formation and insufficient mesh integration has been found as main reason for recurrences. Therefore, the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable.

Materials and methods

A polyvinylidenfluoride mesh material (PVDF) was constructed and surface modified by plasma-induced graft polymerization of acrylic acid (PVDF + PAAc). Surface supplementation was sought by binding of gentamicin to the provided active sites of the grafted mesh surfaces (PVDF+PAAc+Gentamicin). In vivo modulation of collagen formation was evaluated in a standardized animal model where an abdominal wall replacement was performed in 45 Sprague–Dawley rats. Seven, 21, and 90 days after mesh implantation, collagen/protein ratio and the collagen type I/III ratio as well as the expression of type I alpha 1 collagen mRNA (SYBR Green real-time RT-PCR) were analyzed at the perifilamentary region. Additionally, expression of matrix metalloproteinases (MMP-8/-13) has been investigated immunohistochemically.

Results

Implantation of the PVDF + PAAc + Gentamicin mesh induced a significantly decreased expression of MMP-8 and MMP-13 at the interface 21 and 90 days after implantation compared to the other groups. Whereas no significant effect was observed comparing the overall collagen/protein ratio, the quality of collagen formation expressed by the collagen type I/III ratio showed significantly higher ratios around the PVDF + PAAc + Gentamicin mesh 21 and 90 days after implantation. Correspondingly, an up to 5.3-fold expression of type I alpha 1 collagen mRNA was found.

Conclusion

The present data confirm that a surface modification of PVDF mesh samples using plasma-induced graft polymerization of acrylic acid and supplementation of gentamicin is able to improve scar quality and mesh integration.

Keywords

Mesh Collagen type I/III ratio Gentamicin Surface modification PVDF